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Deborah A. Farrell BSN Jane A. Oski, MD, MPH Epidemic Response Team

Implementation of a Mandatory Employee Influenza Vaccination Program in a Rural Tribal Health Care Facility. Deborah A. Farrell BSN Jane A. Oski, MD, MPH Epidemic Response Team Tuba City Regional Health Care Corporation. The Setting.

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Deborah A. Farrell BSN Jane A. Oski, MD, MPH Epidemic Response Team

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  1. Implementation of a Mandatory Employee Influenza Vaccination Program in a Rural Tribal Health Care Facility Deborah A. Farrell BSN Jane A. Oski, MD, MPH Epidemic Response Team Tuba City Regional Health Care Corporation

  2. The Setting • Tuba City Regional Health Care Corporation (TCRHCC) is a 55-bed tribal facility located on the Navajo Nation in northeastern Arizona. • The facility employs an average of 1076 health care personnel (HCP) and provides approximately 180,000 outpatient visits per year. • The majority of HCPs are American Indians (AI) with close ties to the community and extensive clan relationships.

  3. Problem • In the 2009 Influenza A (H1N1) Pandemic, the mortality rate for American Indians (AI) and Alaska Natives (AN) was 4 times higher compared to other racial/ethnic populations. • Disproportionate number of H1N1 influenza deaths among AI/AN’s in 12 states representing 50% of the AI/AN population. • Total 426 deaths with 42 (9.9%) among AI/AN’s. • Majority of the AI/AN deaths: Arizona (16) & New Mexico (8). • 50% of the total AI/AN population falls into one of the categories of increased risk for medical complications from influenza.

  4. HCP Influenza Vaccination The CDC estimates HCP vaccination rates at 30% to 40%.

  5. Mandatory Employee Vaccination • Just do the right thing!

  6. Planning/Implementation • Feb 2010: Epidemiology Response Team (ERT) identifies need for change. • May: Nurse Executive Council unanimously passes policy. • July: Medical Executive Committee passes policy by a 20-5 vote. • August: Senior Leadership passes policy. • Sept: Communication to staff. • Oct 7: >500 employees vaccinated. Incentive: $5 Subway cards. • Oct 8 – 31: Mobile cart & flexible hours to capture remaining emp. • Nov 1: 97% vaccinated. 2% declined & wearing masks. 1% unaccounted.

  7. Sustaining • Balance between forces achieved • Departmental enforcement • Potential hires notified • Feedback and recognition to staff • Monitoring

  8. Implications for Advanced Practice Nurses • The Advanced Practice Nurse is the agent of change. • Respected and regarded as a leader among staff. • Knows who to influence, when to influence, and how to influence. • Possess education, skills and integrity to make the change happen. • Sometimes you just need to lead and the others will follow.

  9. Acknowledgements • Nursing Executive Council • Medical Executive Committee • Human Resources • TCRHCC Employees!!!!

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